Jackie Johnson, a 23-year-old single mother of two, lives on a street in South Memphis that has more vacant lots and abandoned houses than families.
“I had a couch, but I gave it away,” Johnson said as she sat on a plastic toybox in her chair-less, 500-square-foot apartment. “I keep space open because I have children. They need space to play and they can’t really play outside here.”
Johnson was halfway through her senior year in high school when she had her first child, Cordale. She still graduated on time from nearby Hollis F. Price Middle College High.
She was halfway through her fourth year at LeMoyne-Owen College when she had her second child, daughter Markel. She is scheduled to graduate in May with a bachelor’s degree in business administration.
“All these statistics they have say when you have a child young in high school like I did, you’re likely not to finish high school or go to college or even keep your kids,” Johnson said. “I’m going to beat all of those statistics.”
Those statistics are grim.
The number of teenagers who give birth in Shelby County has declined by more than half in the past 15 years, from more than 2,000 a year to fewer than 1,000.
And yet teen births still negatively impact the level of physical and cognitive impairment in the community more than any other factor, including violence, disease and poverty.
That’s one of the key findings of the About Us Work Index, a new analysis of Shelby County’s potential socioeconomic strength by opens in a new windowMorph Studio, a data and systems design firm.
“It is critical for local stakeholders to consider the impact of teen birth rate when evaluating what is needed to help all Shelby County residents thrive economically,” said Greg Kotzbauer, Morph’s co-founder and president.
“Impairment” is a term Kotzbauer and co-founder Jarad Bingham use to measure a wide array of physical and cognitive factors that “impair” an adult’s ability to work and, thus, a community’s overall socioeconomic strength.
Adults who report one or more impairments are three times more likely to be unemployed, half as likely to work full-time, and twice as likely to be living in poverty.
The teen birth rate, according to the analysis, is the “key driver” of physical and cognitive impairments in adults ages 16-64 here in Shelby County. In other words, teen birth impacts the broader community as well as the family.
But the analysis, based on an algorithm that uses half a million local, regional and national data points, goes further. It shows that physical and cognitive impairments are the “key drivers” of teen birth rates.
“All of these factors are connected,” said Bingham, a co-founder of Dragonfly Collective, a social development firm in Memphis. “It’s circular. It creates a cycle. A cycle of teen birth. A cycle of lower educational attainment. A cycle of poverty. And so on. We have to understand and address the connections.”
Kotzbauer, a Dartmouth-trained health care analyst, and Bingham, a social entrepreneur and former ordained Memphis minister, hope their research will give the community a clearer picture of the complex connections that perpetuate teen birth, generational poverty and other socioeconomic challenges.
They also hope their insights will give local government, corporate and nonprofit leaders a more complete blueprint to work together more effectively to address those complex connections.
The two men have been meeting with representatives of the Shelby County Health Department, the Urban Child Institute, the School of Public Health at the University of Memphis, and other local organizations.
“A friend once told me that the world wasn’t broken, but the world functions perfectly according to how we’ve designed it,” said Bingham, a former ordained minister. “Morph Studio is trying to provide insights that aid in a redesign.”
The Morph Studio founders believe that redesign begins with insights from the real lives, hard work and hopeful stories of people like Jackie Johnson and her community health educator, Tammy Lewis.
‘Babies don’t come with a manual’
Johnson found out she was pregnant in the spring of her junior year of high school.
“We had just gone on a school field trip to Six Flags,” Johnson said. “I thought, ‘Oh my God, what am I going to do?’ My mom was in jail. I was 17. I didn’t know nothing about being a mama.”
As Johnson spoke, health educator Tammy Lewis sat on the floor next to her, nodding. “Babies don’t come with a manual,” Lewis said. They both laughed.
Lewis, a 49-year-old community health educator for Le Bonheur Children’s Hospital, has been Johnson’s manual for the past five years.
Lewis works for Le Bonheur’s opens in a new windowHealthy Families program. Specially trained educators like Lewis support young, at-risk moms through the first few years of their child’s life.
“Just being there is the main thing,” Lewis said. “The most important thing with my mamas is their trust. If I say I’m gonna be there, I’m there. If I say I’m gonna bring a resource, I bring it.”
Lewis and other educators don’t just help young mothers with prenatal and post-natal care. They help them navigate a broad, complex, and interconnected array of obstacles to their short- and long-term well-being.
They teach them about everything from early child development to career development, supporting their efforts to stay in school and go to college, find job training and a job, safe and affordable housing, reliable transportation, quality and affordable childcare, and deal with family dynamics.
“Ms. Tammy didn’t cut me no slack, but she always has my back,” Johnson said. “She made me look within myself and dig deep, think about my goals for me and my children. She’s not just an educator. She became family.”
The Morph Studio founders believe the key to addressing a community’s socioeconomic challenges can be found in the real and complicated lives and experiences of people like Johnson and Lewis.
“Creating a strategy that provides the greatest opportunity for all residents to thrive is challenging and complex,” Kotzbauer said.
The complexities can’t be diagnosed with a single statistic such as teen birth rate or poverty rate.
“A clinician doesn’t diagnose the whole-person health of a patient or suggest a treatment plan by just looking at one measure, say their temperature or their blood pressure,” Kotzbauer said.
“The same is true for a community’s overall health and well-being. It shouldn’t focus on one measure. The plan must include actions focused on the interrelationship between a multitude of factors. This is one reason we built the model we did. To provide communities with the key factors as a whole, not as one measure of focus.”
In other words, when Jackie Johnson got pregnant at age 17, it was not a teen birth matter. Or a health care matter. Or an education matter. Or a poverty matter.
It was a Jackie Johnson matter that required her and others to address the multiple, interconnected factors that might keep her and her child from surviving and thriving.
“There are so many barriers out there for teen moms,” said Shandrian Guinn, manager of community outreach programs at Le Bonheur.
Guinn has spent the past 15 years working in various roles to help young mothers and their children find the resources they need to survive and thrive. That includes three years at Child Protective Services and three years in LeBonheur’s neonatal ICU.
“Every teen mother and every situation is unique,” Guinn said. “The systems that are in place don’t always work well together to help unique individuals and circumstances. We should start with the mom. What does she need? What does her child need? Your past does not have to determine your future.”
‘Help them take care of mama’
Jackie Johnson’s future sat with her on the floor on her apartment, smiling and laughing as she read a colorful children’s book with them.
“What’s that?” asked Cordale, pointing at a picture in the book. Cordale, who will turn 5 in December, is in preschool at Downtown Elementary.
“That’s a Kangaroo rat,” Johnson said.
“Ewww,” Cordale said. He scrunched his nose and flipped the page.
Markel, who just turned 1, looked at the book and watched her brother. She goes to Porter-Leath’s opens in a new windowEarly Head Start program in South Memphis. Her brother also attended Porter-Leath’s program.
Lewis helped Johnson get her kids in the program.
“My teen moms especially are dealing with so many challenges,” Lewis said. “You help them take care of their babies. You also got to help them take care of mama. As they become more self-sufficient, I can step back.”
Women who give birth as teenagers are many times more likely than others to drop out of high school, never attend college, and experience unemployment, under-employment and homelessness.
They are more likely to have a child placed in foster care, and to experience maternal depression, physical violence, and other physical and cognitive health problems that can lead to bankruptcy, jail or the morgue.
As a result, their children are more likely than others to be impoverished, undereducated, grow up in disadvantaged families and neighborhoods, experience violence, poor health and other forms of trauma — and become teen parents themselves, perpetuating the cycle.
Unless and until the multiple causes and consequences of teen birth are addressed.
“That’s the key,” Kotzbauer said. “Resources should be allocated to the strongest contributors to equitable health and well-being. And that allocation has to be informed by data that measures all potential factors.”
Morph Studio’s About Us Work Index includes 200 measures of health and well-being, from birth to death, that impact the workforce. It incorporates national and regional as well as local data.
Unlike most other analytical platforms, the Index doesn’t simply show the result of publicly available data (for example, the number or rate of individuals in poverty).
The Index uses a model that evaluates a variety of whole-person data to pinpoint the primary factors that give the working population in a community the best opportunity to thrive.
That’s what makes the teen birth rate finding so important.
“The impact of teen birth is not solely on the teen mother and child,” Kotzbauer said. “It impacts the family, the local network, the broader community. There must be coordinated actions addressing multiple health factors to improve the community’s overall health and well-being.”
A safety network, not a net
Tammy Lewis has been visiting Jackie Johnson for nearly five years. Those regularly scheduled visits, at first weekly, then monthly, will end in December when Cordale turns 5.
“You’re ready. You got this,” Lewis told Johnson as they sat with the children.
“I know, but I don’t feel ready,” Johnson replied.
“I understand. I wasn’t a teen mom but my sister was,” Lewis said.
“You know the struggle,” Johnson said.
“Lord, yes, I do,” Lewis replied. “I’ve got 18 Jackies. One has triplets. One has twins. A lot of them had NICU babies, babies who spent weeks in neonatal intensive care. Some are homeless or in jail. I’m their advocate.”
The Morph Studio founders believe the key to improving the socioeconomic health and well-being of Shelby and other counties is found in programs like Le Bonheur’s Healthy Families.
It’s not just a safety net. It’s a health and safety network — an integrated community network designed to encourage, enable and empower the health and well-being of individuals like Jackie Johnson.
Kotzbauer and Bingham have developed three indexes they believe measure and reflect three fundamental features of well-being:
The Work Index, which identifies the key factors leading to physical or cognitive impairments that limit the ability of the county’s adult population to work at full-capacity.
The Rest Index, which identifies the key factors leading to insufficient sleep among adults in the county.
“Sleep deficiency is related to depression, having difficulty making decisions, solving problems, controlling your emotions and behavior, and coping with change,” Kotzbauer said. “For adolescents, the impact of less sleep alone can have lasting impacts on future brain health and physical health.”
The Play Index, which identifies the key factors leading to physical inactivity among the adult population in the county.
“Until now, I’ve looked at data as a helpful tool for understanding trends,” Bingham said. “I hope that Morph will help us see through the numbers to the real world: to you and me and the real people beneath them.”
Real people like Jackie Johnson.
When Cordale was 2, Johnson spent two months at the Salvation Army’s New Directions Family Residence, a faith-based shelter for women and children experiencing homelessness.
“Me and my mom were arguing,” Johnson said. “She put me out. I thought, ‘Oh my God, I’m in a homeless shelter.’ But my son loved it there. I had my own room, and the women there were very supportive.”
With Lewis’ encouragement and support, Johnson kept working, going to school, and staying connected to family, including the young fathers of Cordale and Markel.
“Their fathers are starting to help out, now,” Johnson said. “As young parents, we are learning how to communicate better and put our differences aside and focus on the children.”
After, Johnson left the shelter and moved into her tiny apartment in South Memphis, with temporary financial support from MIFA’s Rapid Rehousing program.
She is taking two classes at LeMoyne this semester — managerial accounting and intermediate Spanish.
She’s paying for college with a Tennessee Promise Scholarship and a Pell grant.
She’s paying her bills with a part-time job at a local vending machine company and an internship with a local nonprofit.
“Children are a tremendous blessing, but it’s a battle, too,” Johnson said. “There’s so much to do. I gotta be determined. I gotta keep going.”
“You will,” said Lewis, who was sitting on the floor with the family. “Look at all you’ve accomplished so far.”
UPDATE: Jackie Johnson graduated from LeMoyne-Owen College on May 13, 2023. She earned a bachelor’s degree in business administration with a focus on accounting. “I feel like a weight was lifted off. I’m just happy,” she said.
Jackie’s mother and two children attended the graduation ceremony. So did Tammy Lewis. “Jackie beat the odds and did what statistics said she could not do,” Lewis said. “It was a sweet, sweet moment.”
Hope in Memphis is a recurring series about people who are working every day in Memphis to defy and defeat crime and violence, poverty and homelessness, child abuse and neglect, inequity, intolerance and ignorance.
This story first appeared at dailymemphian.com under an exclusive use agreement with The Institute.